Increasingly, the question of what we eat and how it affects our health is a subject that is important not just to those concerned about nutrition but to environmentalists. Kelly D. Brownell, a psychologist who is director of the Rudd Center for Food Policy and Obesity at Yale University, has been a leading researcher into America’s obesity epidemic and its links to the practices of the food industry. Author of the 2004 book, Food Fight, Brownell has recently become interested in the connections between obesity, the environment, and hunger, believing that sustainably growing and producing more nutritious foods can help solve each of these challenges.
Recently, Brownell and Kenneth E. Warner — a prominent tobacco researcher who is Dean of the University of Michigan’s School of Public Health — met at a conference and began discussing the similar legal, political, and business strategies traditionally employed by “Big Tobacco” and the tactics now being used by “Big Food.” Struck by the common playbook that both industries have used and concerned about the public health impacts of industry actions, Brownell and Warner decided to explore the topic more deeply. The result was a paper published earlier this year in the health policy journal, the Milbank Quarterly: “The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?”
As Brownell explained in an interview with Yale Environment 360 senior editor Fen Montaigne, many of the tactics currently being used by Big Food now mirror those used by U.S. tobacco giants as they successfully fought off regulation for decades, thereby contributing to the deaths of millions of Americans. According to Brownell and Warner, the common strategies include dismissing as “junk science” peer-reviewed studies showing a link between their products and disease; paying scientists to produce pro-industry studies; sowing doubt in the public’s mind about the harm caused by their products; intensive marketing to children and adolescents; frequently rolling out supposedly “safer” products and vowing to regulate their own industries; denying the addictive nature of their products; and lobbying with massive resources to thwart regulatory action.
Yale Environment 360: Can you tell me about the genesis of the paper?
Kelly Brownell: It came about as a result of a meeting I went to on cancer, where I met Ken Warner, an economist who’s done a lot of interesting work on things like tobacco taxes. We talked about the similarities between food industry behavior now and tobacco industry behavior over the last four decades or so and it started to look as if there were a script or a playbook that industry was following.
By any definition, the tobacco industry script had been deadly — and successful for them because they forestalled government action. They had convinced the public that tobacco wasn’t as bad as it really was. They fought off lawsuits. They got government to delay many (actions).
We simply didn’t want the food industry to be able to get away with some of those same tactics. The public has become skeptical of food industry behavior and a great deal of concern has been raised about things like marketing to children, selling unhealthy foods in schools. That means the industry is at a crossroads. They can behave as tobacco did, which is lie about the science, distort the truth, and buy up the scientists. Or they can come face-to-face with the reality that some of their products are helping people and some are hurting, and we need to shift the balance.
There are some differences in the industries. Tobacco was one product — cigarettes — and about half a dozen big companies that sold it. With food, there are hundreds of companies and many thousands of products. But the behavior of the industry shows some pretty striking similarities.
e360: I’d like to have you take us through some of those.
Brownell: Well, one is distorting the science and denying the health effects of their products. (Recently) a study was done showing that how close people lived to fast food restaurants predicted their likelihood of obesity. The study was really quite well done. So the National Restaurant Association then came out with their own statement that basically trashed the study and more or less called it junk science.
Now, this is a perfect repeat of what tobacco did for many years. They said smoking doesn’t cause lung cancer. There is not definitive evidence. There aren’t good-enough studies. It’s junk science. It’s just the advocates out to get us. And then they denied that second-hand smoke was killing people. They denied that nicotine was addictive. You can go on and on and on. Well, so here comes a (food) study that’s pretty persuasive. It certainly supports other studies showing a link between fast food consumption and obesity, and what did they do? They trashed the science. They deny it’s the case. In all likelihood, they will pay scientists who they know to produce results favorable to them to disprove this finding. It’s all part of the same script.
e360: You gave another example in your paper of a study about obesity and consumption of sodas. How did the industry react to that?
Brownell: The results couldn’t have been more clear that the more sugared beverages you’re consuming, the more likely you are to have weight problems, the higher your risk for diabetes, and the less likely you are to be eating a healthier diet.
The day the study came out, the trade association for the beverage companies, the American Beverage Association, trashed the study, said it was biased, accused us of cherry-picking only the studies that were in support of our position. And this study was published in the American Journal of Public Health, a good peer-reviewed journal. So attacking it was the first strategy that they used. Then the next strategy they used is they went and they paid some scientists who have produced in the past studies that are favorable to industry positions. They go and they review the literature, and then they do a study that says, “Oh, what do you know? There’s no link between soft drink intakes and these bad outcomes.”
Now, I think if I were them, I would say that’s not how we’re going to behave. When we hear studies that are contrary to our interests, we’re going to say, “Well, we’ll take this seriously and we’ll do what we can to change our products and change our marketing, and we’ll work with the scientists.” But that’s not what they’re doing, for the most part.
e360: You also pointed out the link between what big tobacco did and what big food is doing, trying to sow doubt and confusion in the public’s mind.
Brownell: What the tobacco industry and other industries have done, they realized that if you can instill just enough doubt or impugn the integrity of the people who produce the science or get people second-guessing, then people will say, “Well, we’re not sure if this is the case, so we’re not going to go through with a public policy. We’re not going to sue the industry or come down hard on them for anything.” And so it basically does enough to stall action. And I imagine that’s what the food industry is seeking here. Again, the food industry has some players who are quite progressive and others who are less so.
e360: Tell us about some of the other similar strategies between tobacco and food in terms of trying to keep selling their product.
Brownell: One is the introduction of what the industry will call safer products. And the classic example in tobacco was the introduction of filtered cigarettes. Now, the food industry has done this a lot. They’ve introduced and reformulated products. In some cases, it’s exactly what public health people have been calling for — take out some of the fat, take out some of the sugar, take out some of the salt. But sometimes, they take a little of these things out, but they make it sound as if they’ve taken a lot out. And so the health benefits that get promoted in the marketing aren’t in concert with the actual benefits that have been achieved from reformulating their products.
e360: You mention in your paper the example of a Kentucky Fried Chicken advertisement.
Brownell: Right. Well, KFC is owned by a large parent company called Yum! Brands. And they own Taco Bell and Pizza Hut and some other restaurants. They were very resistant early on to taking the trans fats out of their food and then they got sued by an advocacy organization, and it got to the point where competitors were starting to take out the trans fats and they looked pretty bad for not doing it.
So then they did take out the trans fats reluctantly but started this campaign that inferred that you can now eat this chicken with impunity because the trans fats had been removed. There is one advertisement where the husband came in and the mother and children were sitting there in the counter. The husband looked at the chicken and the wife said, “Guess what?” in words to this effect, “KFC is now free of trans fats.” And so, he lets out a yelp of glee and starts gorging on the chicken. And so, somebody could look at that advertisement and say, “Okay. Well now it doesn’t have trans fats, it means it’s okay to eat it.”
Well in fact, if you swap out trans fat for another kind of fat, there’s no calorie advantage at all. It’s better for your heart because it’s a healthier fat, but there’s no calorie advantage. I like the fact that they took out the trans fat and we need more of that kind of thing happening. But if they oversold the benefits, this could be an example of introducing what the industry could call a safer product but consumption patterns wouldn’t lead it to actually be safer.
e360: What about the similarities of Big Food hitting this theme of personal responsibility?
Brownell: People believe that personal responsibility should be the way we address problems. I don’t have any quarrel with that. It’s probably not a bad place to start, but when this industry behaves in a way that undermines personal responsibility, then we’ve got problems and that’s usually a place where people feel government intervention is warranted.
So with tobacco, you had a clearly addictive substance. So, people would start when they were teenagers. Their ability to behave in a responsible way was being undermined by the marketing and of course the addictive nature of the product. So, that means government could step in and so what do we do? We pass clean air laws, we tax the heck out of cigarettes, we sue the tobacco industry. And society now accepts that as responsible behavior on the part of government because personal responsibility was being eroded.
So the question is, in food, does that same set of conditions exist and does that warrant government response? Well, everybody comes down in a different place, but there certainly are similarities, including very heavy duty marketing of these products, especially to children.
I don’t want to say that personal responsibility is not important, because it certainly is. But in some cases we’ve decided that’s not enough and then government gets involved. With tobacco, with drugs, with alcohol, with immunizations for children, with fluoride in the water, with mandatory airbags in cars, we’ve decided that if we’re serious about these public health things, the government should be involved.
In the food arena, a great example of this would be in New York City, where the health department has banned trans fats in restaurants. So if you go to New York now, you can’t get trans fats in the restaurants. Now you could try to solve that problem of people eating trans fats, and having heart disease as a consequence of it, by personal responsibility. You could say, “Okay, well, let’s educate people about trans fats.” But it’s a pretty hard concept to understand. Restaurants would have to label them. People would have to have options within restaurants, trans fat versus no trans fat. And you see you’d have this complex, burdensome system that would never work. And so, that would be an example where personal responsibility wouldn’t get the job done but government intervention would. And so, in New York City, they’ve decided that we can’t default to personal responsibility there, we need to take action. And that would be an example of a real success story from a public health point of view.
e360: Of course, with tobacco very clearly there was an issue of addiction. But one interesting point you raised is the addiction triggers in substances like caffeine and sugar?
Brownell: We don’t know the answer yet to the question about whether food can trigger an addictive process in the brain. But it’s a darn important question that we need to know. Some addiction researchers have started studying this, including a few animal researchers in the obesity field. And the studies are pretty amazing so far. There are animal studies in the labs and there are brain imaging studies in humans. And what’s been studied the most is sugar, which looks like it has effects on the brain like classic substances of abuse. Now, the magnitude of the effect, the addictive effect isn’t that strong, but it does seem to exist.
Why do we need to know this? Well, people are eating in ways that would suggest that addiction might be a possibility. I mean, people know it’s bad for them to overeat these kinds of foods. But people do this anyway at great peril to their health. And if these foods are behaving on the brain in an addictive way, if that happens, even to a small extent, it could have pretty important public health consequences.
Caffeine becomes a real issue because caffeine is addictive. And some people drink a little of it through beverages, some people drink a lot of it, but so much of it is added to foods now, in things like energy drinks. And now people are putting it in candy bars and in potato chips and jelly beans and selling it as energy versions of things. There’s a version of Butterfinger candy bar out now that’s called Butterfinger Buzz. And it says on the back, “Not recommended for children.” But I mean, who’s buying these things? Caffeine, because it’s so often coupled with calories, could become a real player here that if you’re consuming calories in something that has caffeine in it and the caffeine keeps you coming back for more because of its mildly addictive nature then, again, you’ve got enough to create real issues of health.
e360: You mentioned with big tobacco that there was a massive lobbying effort spending countless millions of dollars to stifle government action. Could you describe the parallels, the efforts to undermine state and local efforts to crack down on fast food and trans fats?
Brownell: There’s a remarkable history there. As you might imagine, the food industry is enormously powerful. And the industry speaks as individual players but also through their trade associations. They have their lobbyists in Washington. They have a lot of money to use for this purpose, and they’re effective. But does this help public health?
New York City was the first city to pass a regulation that restaurants had to post calories on their restaurant menus, or on menu boards in the case of fast food restaurants. How did the restaurant industry respond to this? Well, they responded by lobbying heavily against it, but that didn’t work. Then sued New York City, and finally lost. And so, the regulation is now in effect. When it looked like legal action wasn’t going to help them so much, then they tried to weaken the legislation.
A lot of other places around the country are now passing menu labeling, so the industry has managed to get several legislators in Washington to introduce a national bill that would override anything that can be done at local levels by having a weak national standard. So, there’s a script that tobacco followed that food is following. If there’s no threat, you ignore it. But then when it becomes a reality, you sue. When that doesn’t work, you preempt it nationally.
e360: In order for the food industry not to go down the same deadly path that tobacco went down, could you go into what you might call a good playbook for the food industry?
Brownell: One is to stop playing the personal responsibility card as much as they have. That doesn’t mean that they have to ignore personal responsibility, but they can’t act as if that’s the only reason that people are eating and developing nutrition and weight problems.
Lying about the science, distorting scientific findings, and trashing the messenger, which they very often do — I think that should stop. I believe they should also stop paying scientists to do studies that almost 100 percent of the time favor industry. Marketing unhealthy products to children should stop instantly. And we know what some of these products are that are hurting the health of children.
e360: Can you list a few?
Brownell: Well, sugared beverages would be at the top of the list. Fast foods would be second on that list. Sugared cereals, candy. There’s just no reason at all to market those things to kids. It’s not helping them, it’s hurting them and it shouldn’t be done. There are a number of other issues about responsible marketing practices: not overstating the health benefits, not implying that something is healthier than it really is, not marketing in ways that undermine the parental ability to moderate the health of their children.
Most of all, they should reformulate their products and market the healthier versions as aggressively as possible, I think.
e360: You say that it would be a trap to give the food industry the benefit of the doubt given their past behavior. Why?
Brownell: Well, the tobacco history was so riddled with disaster and we gave them the benefit of the doubt and look at the millions of people that died as a consequence. Why are the motives of the food industry going to be any different? They want to sell as much as they can of their products. But on the other hand, the public is watching them now and government is watching them, plus some of them really may see that selling healthier products is in their best long-term interest.
But it seems to me that defaulting to trusting the industry without any oversight is really a bad idea. And so, at the very least, we should have a set of conditions that we agree on that says, “If industry is to be proven trustworthy, if we’re to grant them self-regulatory authority instead of government coming down on them, then they have to do these things.” Like, for example, they have to work with the public health community to make business priorities. If they make self-regulatory promises like, “We’re going to market less to kids,” there has to be objective evaluation of that and there has to be some effect if they don’t comply.